Laurel Pine Pediatrics LLC

NPI #1982986519 in Laurel, Maryland

Provider Information

NPI Number: 1982986519
Entity Type: Organization
Organization Name: Laurel Pine Pediatrics LLC
Subpart: Yes (part of a larger organization)
Parent Organization: LAUREL PINE PEDIATRICS LLC
Primary Specialty: Pediatrics
Enumeration Date: Sep 9, 2011
Last Updated: Sep 9, 2011

Practice Location

Address: 14333 LAUREL BOWIE RD
Address 2: SUITE 206
City: Laurel
State: Maryland
ZIP Code: 20708
Phone: (301) 362-0506

Authorized Official

Name: DR. WONDU T. WOSSEN, M.D.
Title: PHYSICIAN
Phone: (301) 362-0506

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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